Testing the contiguity of the sleep and fatigue relationship: a daily diary study

SLEEP ◽  
2020 ◽  
Author(s):  
Andrea L Harris ◽  
Nicole E Carmona ◽  
Taryn G Moss ◽  
Colleen E Carney
Keyword(s):  
Sleep Quality ◽  
Hierarchical Linear Modeling ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Cognitive Factors ◽  
Sleep Diary ◽  
Poor Sleep ◽  
Daily Diary Study ◽  
Insomnia Disorder ◽  
The Relationship

Abstract Study Objectives There is mixed evidence for the relationship between poor sleep and daytime fatigue, and some have suggested that fatigue is simply caused by lack of sleep. Although retrospective measures of insomnia and fatigue tend to correlate, other studies fail to demonstrate a link between objectively disturbed sleep and fatigue. The current study prospectively explored the relationship between sleep and fatigue among those with and without insomnia disorder. Methods Participants meeting Research Diagnostic Criteria for insomnia disorder (n = 33) or normal sleepers (n = 32) completed the Consensus Sleep Diary (CSD) and daily fatigue ratings for 2 weeks. Baseline questionnaires evaluated cognitive factors including unhelpful beliefs about sleep and rumination about fatigue. Hierarchical linear modeling tested the within- and between-participant relationships between sleep quality, total sleep time, and daily fatigue ratings. Mediation analyses tested if cognitive factors mediated the relationship between insomnia and fatigue. Results Self-reported nightly sleep quality significantly predicted subsequent daily fatigue ratings. Total sleep time was a significant predictor of fatigue within, but not between, participants. Unhelpful sleep beliefs and rumination about fatigue mediated the relationship between insomnia and fatigue reporting. Conclusions The results suggest that perception of sleep plays an important role in predicting reports of daytime fatigue. These findings could be used in treatment to help shift the focus away from total sleep times, and instead, focus on challenging maladaptive sleep-related cognitions to change fatigue perception.

scholarly journals An investigation of the relationship between sleep and fatigue in those with and without insomnia

2021 ◽  
Author(s):  
Andrea L. Harris
Keyword(s):  
Sleep Quality ◽  
Linear Models ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Diary ◽  
Poor Sleep ◽  
Sleep Quantity ◽  
Cognitive Behavioural ◽  
Multi Method Approach ◽  
The Relationship

There is currently mixed evidence for the relationship between poor sleep and daytime fatigue. It is well documented that retrospective measures of insomnia and fatigue are highly correlated with one another. However, other studies fail to demonstrate a link between objectively less sleep and fatigue; that is, individuals with shorter sleep times do not necessarily report increased fatigue. As such, the relationship between these two constructs remains unclear. The current investigation will help to elucidate the complex relationship between sleep and fatigue among those with and without insomnia by advancing the existing literature in two important ways. First, this study proposed to examine the temporal relationship between sleep and fatigue across two weeks, thereby investigating whether sleep and fatigue occur in accordance with one anotherover time. Second, this study utilized a multi-method approach by collecting subjective (i.e.,sleep diary) and objective (i.e., actigraphy) measures of sleep, as well as retrospective (i.e.,visual analogue scales: VAS) and prospective (i.e., momentary ratings) measures of fatigue. Two separate hierarchical linear models were used to test whether sleep (measured by sleep quality and total sleep time) predicted daytime fatigue on the VAS and actigraph, respectively. The secondary objective asked whether cognitive-behavioural variables (i.e., maladaptive sleep beliefs, fear and avoidance of fatigue, and fatigue-based rumination) may help account for the relationship between sleep and fatigue using mediation. The results of the primary analyses suggested that sleep quality significantly predicted VAS fatigue ratings, whereas total sleep time was a significant predictor of fatigue within- but not between-persons. No significant relationships were found between objective measures of sleep and momentary fatigue ratings. Finally, each of the cognitive-behavioural variables, with the exception of avoidance of fatigue, were significant mediators of the relationship between sleep and fatigue. The results demonstrated that compared to sleep quantity, our perception of sleep may play a more important role in predicting reports of daytime fatigue. These findings could help decrease the burden that individuals with insomnia place on their total sleep times, and instead, treatment could focus on challenging maladaptive sleep-related cognitions, which ultimately could lessen the overall sleep-related anxiety.

scholarly journals An investigation of the relationship between sleep and fatigue in those with and without insomnia

2021 ◽  
Author(s):  
Andrea L. Harris
Keyword(s):  
Sleep Quality ◽  
Linear Models ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Diary ◽  
Poor Sleep ◽  
Sleep Quantity ◽  
Cognitive Behavioural ◽  
Multi Method Approach ◽  
The Relationship

There is currently mixed evidence for the relationship between poor sleep and daytime fatigue. It is well documented that retrospective measures of insomnia and fatigue are highly correlated with one another. However, other studies fail to demonstrate a link between objectively less sleep and fatigue; that is, individuals with shorter sleep times do not necessarily report increased fatigue. As such, the relationship between these two constructs remains unclear. The current investigation will help to elucidate the complex relationship between sleep and fatigue among those with and without insomnia by advancing the existing literature in two important ways. First, this study proposed to examine the temporal relationship between sleep and fatigue across two weeks, thereby investigating whether sleep and fatigue occur in accordance with one anotherover time. Second, this study utilized a multi-method approach by collecting subjective (i.e.,sleep diary) and objective (i.e., actigraphy) measures of sleep, as well as retrospective (i.e.,visual analogue scales: VAS) and prospective (i.e., momentary ratings) measures of fatigue. Two separate hierarchical linear models were used to test whether sleep (measured by sleep quality and total sleep time) predicted daytime fatigue on the VAS and actigraph, respectively. The secondary objective asked whether cognitive-behavioural variables (i.e., maladaptive sleep beliefs, fear and avoidance of fatigue, and fatigue-based rumination) may help account for the relationship between sleep and fatigue using mediation. The results of the primary analyses suggested that sleep quality significantly predicted VAS fatigue ratings, whereas total sleep time was a significant predictor of fatigue within- but not between-persons. No significant relationships were found between objective measures of sleep and momentary fatigue ratings. Finally, each of the cognitive-behavioural variables, with the exception of avoidance of fatigue, were significant mediators of the relationship between sleep and fatigue. The results demonstrated that compared to sleep quantity, our perception of sleep may play a more important role in predicting reports of daytime fatigue. These findings could help decrease the burden that individuals with insomnia place on their total sleep times, and instead, treatment could focus on challenging maladaptive sleep-related cognitions, which ultimately could lessen the overall sleep-related anxiety.

Sleep and Psychological Abuse Among Cohabiting Couples: A Pilot Study

Partner Abuse ◽  
2017 ◽  
Vol 8 (4) ◽  
pp. 347-360
Author(s):  
Sharon Rose ◽  
Linda Berg-Cross ◽  
Nancy A. Crowell
Keyword(s):  
Sleep Quality ◽  
Relationship Satisfaction ◽  
Sleep Deprivation ◽  
Daytime Sleepiness ◽  
Psychological Abuse ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Cohabiting Couples ◽  
Survey Results ◽  
The Relationship

This study explored the relationship between psychological abuse and sleep deprivation among nonclinical cohabiting couples. Thirty-one couples participated in completing a variety of sleep measures, a psychological abuse scale, and a relationship satisfaction survey. Results indicated a persistent relationship between everyday sleep deficits (sleep quality, daytime sleepiness, and self-reported total sleep time) and the perceived perpetration and felt victimization of psychological abuse. Overall, results were as hypothesized, but there were gender differences. Male psychological abuse victimization and perpetration were significantly related to sleep quality and daytime sleepiness, but for women, only sleep duration was predictive of felt victimization. The sleep variables were significantly related to women’s—but not men’s—reported relationship satisfaction. Overall, minimal sleep deprivation appears to be related to increased psychological abuse perpetration and victimization even among a normative population scoring outside the clinical range on these measures. Implications for prevention and treatment are discussed.

scholarly journals The relationship between shift work and sleep patterns in nurses

2013 ◽  
Vol 18 (3) ◽  
pp. 763-768 ◽  
Author(s):  
Milva Maria Figueiredo De Martino ◽  
Ana Cristina Basto Abreu ◽  
Manuel Fernando dos Santos Barbosa ◽  
João Eduardo Marques Teixeira
Keyword(s):  
Sleep Quality ◽  
Shift Work ◽  
Pittsburgh Sleep Quality Index ◽  
Sleep Diary ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Work Habits ◽  
Significant Difference ◽  
Nighttime Sleep ◽  
The Relationship

The scope of this study was to evaluate the sleep/wake cycle in shift work nurses, as well as their sleep quality and chronotype. The sleep/wake cycle was evaluated by keeping a sleep diary for a total of 60 nurses with a mean age of 31.76 years. The Horne & Östberg Questionnaire (1976) for the chronotype and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality were applied. The results revealed a predominance of indifferent chronotypes (65.0%), followed by moderately evening persons (18.3%), decidedly evening persons (8.3%), moderately morning persons (6.6%) and decidedly morning persons (1.8%). The sleep quality perception was analyzed by the visual analogical scale, showing a mean score of 5.85 points for nighttime sleep and 4.70 points for daytime sleep, which represented a statistically significant difference. The sleep/wake schedule was also statistically different when considering weekdays and weekends. The PSQI showed a mean of 7.0 points, characterizing poor sleep quality. The results showed poor sleep quality in shift work nurses, possibly due to the lack of sport and shift work habits.

346 Semi-Individualized Acupuncture for Insomnia Disorder: A Randomized Sham-Controlled Trial

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A138-A138
Author(s):  
Jerry Wing-Fai Yeung ◽  
Branda Yee-Man Yu ◽  
John Yuen ◽  
Janice Ho ◽  
Ka-Fai Chung ◽  
...  
Keyword(s):  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Diary ◽  
Linear Mixed Effect Model ◽  
Mixed Effect ◽  
Insomnia Symptom ◽  
Insomnia Disorder ◽  
Wrist Actigraphy ◽  
Significant Difference ◽  
Sleep Parameters

Abstract Introduction Acupuncture is an alternative treatment for improving sleep quality and the effectiveness is thought to be optimized with an individualized approach resembling real practice. However, existing evidence is limited by methodological shortcomings due to blinding issues, standardized measures, and diagnostic procedures. It was of the present study’s interest to examine the efficacy and safety of semi-individualized acupuncture treatment on insomnia. Methods Adults with DSM-5 insomnia disorder (n = 140) were randomized with 1:1 allocation to a 4-week intervention traditional acupuncture (TA) or validated non-invasive sham acupuncture (SA). The selection of acupoints was semi-individualized by the acupuncturist. As the primary outcome, the sleep efficiency (SE) by sleep diary was assessed at baseline, 1-week posttreatment, and 5-week posttreatment. Other sleep parameters derived from sleep diary, the wrist-actigraphy-derived sleep parameters, insomnia symptom severity, anxiety, and depressive symptoms, as well as the health-related quality of life, were also evaluated. Results Although linear mixed-effect model revealed both groups did not attain significant difference in sleep-diary-derived SE and other outcome measures (all P > 0.05), TA promising effect on improving insomnia symptom (within-group effect size, d = 1.13 & 1.30 at 1-week & 5-week posttreatment respectively) and also a higher proportion of subjects achieved SE ≥ 85% compared with SA (55.6% versus 36.4% at week 9, P = 0.03). Besides, subjects in TA group reported significantly greater improvement in both the total sleep time (TST) derived from sleep diary and actigraph than those in the SA group at 1-week posttreatment (difference in mean changes from baseline: sleep diary = 22.0 min, p = 0.01; actigraphy =18.8 min, P = 0.02) but not 5-week posttreatment. Conclusion This study is the first to evaluate the effect of the TCM-theory-based individualized acupuncture on sleep using a sham-control design. A 4-week semi-individualized acupuncture is able to significantly increase total sleep time with few adverse events. Support (if any) Research Grants Council of Hong Kong, Early Career Scheme (Project no.: 25101017)

scholarly journals A Community-Based Study on the Association Between Insomnia and Hypothalamic-Pituitary-Adrenal Axis: Sex and Pubertal Influences

2014 ◽  
Vol 99 (6) ◽  
pp. 2277-2287 ◽  
Author(s):  
Jihui Zhang ◽  
Siu-Ping Lam ◽  
Shirley Xin Li ◽  
Ronald C. W. Ma ◽  
Alice P. S. Kong ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Outcome Measures ◽  
Hpa Axis ◽  
Salivary Cortisol ◽  
Sleep Diary ◽  
Poor Sleep ◽  
Adult Males ◽  
Community Based ◽  
Hypothalamic Pituitary Adrenal ◽  
Insomnia Disorder

Context: The association between insomnia disorder and the hypothalamic-pituitary-adrenal (HPA) axis needs to be explored in both adults and adolescents. Objectives: Our objective was to investigate the associations of the HPA axis (via serial salivary cortisol) with insomnia disorder and subjective and objective sleep quality in a community-based study. Design and Setting: This was a community-based case-control family study. Participants: Participants included 205 adolescents (14.2 ± 2.8 years old, 51.7% females, and 57 with insomnia) and 244 adults (46.4 ± 4.1 years old, 52.8% females, and 69 with insomnia). Main Outcome Measures: Outcome measures included a diagnostic interview for assessment of insomnia disorder, 3-day actigraphy and sleep diary, and serial salivary cortisol measurement. Results: Adults with insomnia had a significantly greater cortisol awakening response (CAR) reference to increase (CARi) but a comparable CAR reference to ground and a comparable cortisol level during afternoon and evening when compared with noninsomniac adults. The association between insomnia disorder and larger CARi was also found in adolescents at late/post puberty but not in pre/early pubertal adolescents. There was an interaction effect between sex and insomnia disorder on CARi level with adult females having larger CARi than adult males. Among subjects with insomnia disorder, those with lower subjective sleep efficiency had higher cortisol levels in the late evening (10:00 pm) in both adults and adolescents. Conclusions: Our study suggests that a series of insomniac indices at both syndromal and symptomatic levels including clinical diagnosis and poor sleep quality are associated with dysfunction of the HPA axis. The association between insomnia and increased CARi emerges at late puberty, and the sex difference in this association occurs in adulthood but not in adolescence.

scholarly journals Does media use before bedtime affect the sleep of psychosomatic rehabilitation patients?

2020 ◽  
Vol 24 (4) ◽  
pp. 253-258
Author(s):  
Jasmin Faber ◽  
Indra Steinbrecher-Hocke ◽  
Peter Bommersbach ◽  
Angelika A. Schlarb
Keyword(s):  
Sleep Quality ◽  
Media Use ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Subjective Sleep Quality ◽  
Psychosomatic Rehabilitation ◽  
Sleep Parameters ◽  
Rehabilitation Clinic ◽  
The Relationship

Abstract Objective Media use can affect sleep. However, research regarding various populations is sparse. The objective of this study was to examine the relationship between media use directly before bedtime and various sleep parameters in patients of a psychosomatic rehabilitation clinic. Methods Patients from a German psychosomatic rehabilitation clinic were tested regarding subjective sleep quality and insomnia symptoms based on questionnaires such as the Pittsburgh Sleep Quality Index (PSQI). Eligible patients also completed an additional sleep log over a period of 1 week. A total of 347 insomnia patients were enrolled, with a mean age of 49.77 years (range 22–64 years; median = 52 years). 57.5% of the patients were 50 years or older. Results Analysis showed that media use and various sleep diary parameters such as total sleep time (r = −0.386, p = 0.042; rTST2 = 0.149) and sleep efficiency (r = −0.507, p = 0.006; rSE2 = 0.257) were significantly associated. In detail, more media consumption was associated with less total sleep time and a lower sleep efficiency. The same result was found for media use and sleep efficiency on weekdays (r = −0.544, p = 0.002; rSE2 = 0.296), but not for other sleep parameters. However, media use time and subjective sleep quality were not significantly correlated, r = −0.055, p = 0.768. Conclusion This study, which is the first to examine the relation between media use and sleep in patients of a psychosomatic rehabilitation clinic, suggests a significant association between media use and sleep duration as well as sleep efficiency. However, more research is needed to investigate the relationship between media use and sleep in more detail, to increase patients’ quality of life and to incorporate these findings into the daily life of clinicians and therapists as well as into sleep hygiene education and sleep trainings.

scholarly journals Hospitalized COVID-19 Patients Were Five Times More Likely to Suffer From Total Sleep Deprivation Compared to Non-COVID-19 Patients; an Observational Comparative Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Eva S. van den Ende ◽  
Kim D. I. van Veldhuizen ◽  
Belle Toussaint ◽  
Hanneke Merten ◽  
Peter M. van de Ven ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Comparative Study ◽  
Sleep Deprivation ◽  
Total Sleep Time ◽  
Short Form ◽  
Sleep Time ◽  
Hospital Environment ◽  
Poor Sleep ◽  
Total Sleep Deprivation ◽  
Patient Reported

Objectives: Sleeping disorders are a common complaint in patients who suffer from an acute COVID-19 infection. Nonetheless, little is known about the severity of sleep disturbances in hospitalized COVID-19 patients, and whether these are caused by disease related symptoms, hospitalization, or the SARS-CoV-2 virus itself. Therefore, the aim of this study was to compare the quality and quantity of sleep in hospitalized patients with and without COVID-19, and to determine the main reasons for sleep disruption.Methods: This was an observational comparative study conducted between October 1, 2020 and February 1, 2021 at the pulmonary ward of an academic hospital in the Netherlands. This ward contained both COVID-19-positive and -negative tested patients. The sleep quality was assessed using the PROMIS-Sleep Disturbance Short Form and sleep quantity using the Consensus Sleep Diary. Patient-reported sleep disturbing factors were summarized.Results: A total of 79 COVID-19 patients (mean age 63.0, male 59.5%) and 50 non-COVID-19 patients (mean age 59.5, male 54.0%) participated in this study. A significantly larger proportion of patients with COVID-19 reported not to have slept at all (19% vs. 4% of non-COVID-19 patients, p = 0.011). The Sleep quality (PROMIS total score) and quantity (Total Sleep Time) did not significantly differ between both groups ((median PROMIS total score COVID-19; 26 [IQR 17-35], non-COVID-19; 23 [IQR 18-29], p = 0.104), (Mean Total Sleep Time COVID-19; 5 h 5 min, non-COVID-19 mean; 5 h 32 min, p = 0.405)). The most frequently reported disturbing factors by COVID-19 patients were; ‘dyspnea’, ‘concerns about the disease’, ‘anxiety’ and ‘noises of other patients, medical staff and medical devices’.Conclusion: This study showed that both patients with and without an acute COVID-19 infection experienced poor quality and quantity of sleep at the hospital. Although the mean scores did not significantly differ between groups, total sleep deprivation was reported five times more often by COVID-19 patients. With one in five COVID-19 patients reporting a complete absence of night sleep, poor sleep seems to be a serious problem. Sleep improving interventions should focus on physical and psychological comfort and noise reduction in the hospital environment.

scholarly journals Sleep in children with Smith–Magenis syndrome: a case–control actigraphy study

SLEEP ◽  
2019 ◽  
Vol 43 (4) ◽  
Author(s):  
Jayne Trickett ◽  
Chris Oliver ◽  
Mary Heald ◽  
Hayley Denyer ◽  
Andrew Surtees ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Total Sleep Time ◽  
Sleep Onset ◽  
Sleep Time ◽  
Individual Variability ◽  
Poor Sleep ◽  
Inverse Association ◽  
Linear Modeling ◽  
Hygiene Practices ◽  
And Behavior

Abstract Study Objectives The objectives of the study were (1) to compare both actigraphy and questionnaire-assessed sleep quality and timing in children with Smith–Magenis syndrome (SMS) to a chronologically age-matched typically developing (TD) group and (2) to explore associations between age, nocturnal and diurnal sleep quality, and daytime behavior. Methods Seven nights of actigraphy data were collected from 20 children with SMS (mean age 8.70; SD 2.70) and 20 TD children. Daily parent/teacher ratings of behavior and sleepiness were obtained. Mixed linear modeling was used to explore associations between total sleep time and daytime naps and behavior. Results Sleep in children with SMS was characterized by shorter total sleep time (TST), extended night waking, shorter sleep onset, more daytime naps, and earlier morning waking compared to the TD group. Considerable inter-daily and inter-individual variability in sleep quality was found in the SMS group, so caution in generalizing results is required. An expected inverse association between age and TST was found in the TD group, but no significant association was found for the SMS group. No between-group differences in sleep hygiene practices were identified. A bidirectional negative association between TST and nap duration was found for the SMS group. In the SMS group, increased afternoon sleepiness was associated with increased irritability (p = .007) and overactivity (p = .005). Conclusion These findings evidence poor sleep quality in SMS and the need to implement evidence-based interventions in this population.

scholarly journals 0840 Sleep Quality in Clinically Indicated In-Laboratory Polysomnography

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A320-A320
Author(s):  
R H Roth ◽  
E Harrison ◽  
H Kang ◽  
J Lobo ◽  
J Logan ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Sleep Quality ◽  
Total Sleep Time ◽  
Multivariable Analysis ◽  
Sleep Time ◽  
Apnea Hypopnea Index ◽  
Poor Sleep ◽  
Future Studies ◽  
Antidepressant Use ◽  
Male Sex

Abstract Introduction Few studies have explored how patients sleep or what characteristics might be predictive of poor sleep during clinically-indicated polysomnography (PSG) in an in-laboratory setting. Methods We reviewed clinically indicated diagnostic PSG studies completed over a 10-year period in a single academic sleep center. Total sleep time (TST) and sleep efficiency (SE) were used as proxies for sleep quality. Patients were categorized as normal or poor sleepers based on TST <4 hours or SE <50%. Multivariate linear and logistic regression analyses were performed to determine factors associated with sleep quality while controlling for demographics, medications, comorbidities and measures of sleep. Results We included 4957 patients, who were mostly female (58.9%), middle-aged (52.9 y), Caucasian (69.3%), and overweight or obese (91.3%). 3682 patients (74.2%) were diagnosed with sleep apnea (Apnea Hypopnea Index(AHI)>5/hr). Average TST was 5.75±1.43 hours (Interquartile range [IQR] = 4.94 - 6.73) and average SE was 75.1%±16.1% (IQR=66.9 - 87.2). TST and SE were lower for males compared to females (5.48 vs 5.93 hr, p<0.001; 73% vs 77%, p<0.001). In multivariable analysis, older age (TST: OR = 1.04, 95% CI:[1.03,1.05]; SE: OR = 1.04, 95% CI:[1.04,1.05]), male sex (TST: 1.38,[1.14,1.68]; SE: 1.34,[1.07,1.68]), normal body habitus (TST: 1.47,[1.02,2.08]; SE: 1.51,[1.01,2.27]) and a higher AHI (TST: 1.02,[1.02,1.03]; SE: 1.02,[1.003,1.03]) were significantly associated with being a poor sleeper for both TST and SE. Antidepressant use was associated with poor sleep for TST (0.77, [0.59,1]), but not for SE (0.98, [0.73,1.3]). Conclusion Sleep quality during the in-laboratory PSG differed by sex, age and presence of sleep apnea. Sleep quality during in-lab PSG is thought to be compromised by obtrusive monitoring and an unfamiliar environment, but average sleep quality may be higher than expected for patients in the laboratory. Future studies should consider examining in-lab sleep quality in different patient populations. Support N/A

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